Alpine ski sport injuries in Swedish Lapland

by Made, Curt, PhD

Abstract (Summary)

Downhill skiing is associated with recreation, youth, speed, aerials and crowded courses which carry increased risk of injuries. The aim of this study was to evaluate downhill sport injuries in a Swedish ski resort.Material and methodsIn a case-control study ongoing 1989/90–2006/07, 3,696 injured skiers were registered. After informed consent the injured were assessed by a physician and asked to answer a questionnaire concerning skier, skiing and injury.ResultsAfter three years 481 injured skiers (41% females, mean age 23) were assessed. The injury rate was 1.13/1,000 skier days. Knee injury was most common (28%), followed by head/neck (13%) and lower leg (11%). Fractures were less common (23%) than sprains (44%). Among skiers below the age of 20, fractures outnumbered sprains. Helmet usage was high among children (<10 years; 83%), but very rare in adults. The injured skiers rarely tested positive for alcohol (1.1%, uninjured 5.0%) and no effect on skiing or injury rates were registered.A one-year follow-up about the ski injury outcome shows that the mean sick leave was 40 days and that 29% still had symptoms.94 injured telemark skiers were assessed over 11 years (females 36%, mean age 28). The ankle was the most common injury location (28%), followed by knee injury (19%) and injuries of head/neck (17%). Beginners suffered most ankle injuries (37%). The use of high-shafted boots increased (24% to 67%), while injuries to the ankle/foot diminished from 35% to 22%.568 snowboard injured were studied over 10 years (females 34%, mean age 19). Snowboard riding increased strongly during the period (<5% to 26%). The injury rate was 3/1,000 skier days. Injuries were mostly located in the upper extremities (54%). Head/neck accounted for 17%. Wrist fracture was the most common diagnosis (20%). Beginners had a higher incidence of lower arm/wrist injuries while advanced riders had more head/neck injuries.1,833 injured alpine skiers were evaluated over 16 years (females 45%, mean age 24). The injury rate was the lowest of all downhill ski sports (1.1/1,000 skier days). The lower extremity was the most common injury location (51%), the knee being the most commonly injured body part. Knee injuries affected females (39%) more often than males (23%). Head/neck injury came second (12%). Lower leg injury was most frequent in children (<10 y; 32%). Sprains were more common (43%) than fractures (22%). Beginners took fewer risks, had more falls and were injured relatively often. Helmet usage increased (25% to 58%). Helmet users reduced their risk of head injury. The severity of injury (AIS 3–6) decreased (3,4% to 1,6%).The over all results (18 years) showed similar injury incidences to the separate studies but a few specific diagnoses, e.g. knee injuries showed variations.ConclusionThe injury rate was highest in snowboarding and lowest in alpine skiing. Knee injury, especially in females, was the most common injury, the upper extremity in snowboarding and the lower extremity in telemark skiing. Helmet usage increased rapidly. Helmets have a protective effect. Ski safety work should focus on risk groups. Lift owners need to take the responsibility for ski safety work.